Why Does My Butt Hurt So Much?

There are lots of things that are a pain in the butt: forgetting your hair tie at the gym, coming home to a sink full of dirty dishes, needing to do laundry…Then, there’s a literal pain in your butt.

Butt pain can come in different forms: shooting pain, cramping, even an irritating “do I have a paper cut down there?” type of pain. No matter which type of pain you’re experiencing, you probably want it gone ASAP.

Here are some common causes of butt pain—plus how to make it stop.

1. You have your period.

Fun fact: Your periods can mess with your poop. Hormone-like compounds called prostaglandins—they make the uterus contract, causing cramps—can stray into the bowel area and cause some people to poop more during their period.

These prostaglandins may cause diarrhoea, too. “Looser stools than normal, having to go to the bathroom more often, and feeling more urgency—like, I gotta go now—are all very common side effects of a sharp rise in prostaglandins,” Dr. Jennifer Gunter, an obstetric-gynaecologist in San Francisco, previously told us.

Severe period cramps can also extend to the lower abdomen, and feel as if they’re affecting your butt area. Great.

There are also two types of hemorrhoids: external and internal. Itching or pain around the anus, along with a lump (an inflamed blood vessel), can signal an external hemorrhoid, per the NIDDK. Internal hemorrhoids also cause rectal pain, and may be accompanied by bleeding.

Hemorrhoids will usually go away on their own (or with a little over-the-counter prescription cream). But if your hemorrhoids don’t go away after a week, or if they cause a lot of pain or occur frequently, then you should check in with your primary care doctor.

3. You have endometriosis.

About 11 percent of women have endometriosis, according to the Office on Women’s Health. Endometriosis happens when tissue that normally lines the uterus (the same stuff that sheds with your period each month) grows outside of the uterus.

The overgrowth of this tissue is most often found on fallopian tubes, ovaries, and the outer surface of the uterus, but it can also also extend to the bowel area. If endometrial tissue grows in the bowel, it can cause painful bowel movements, according to the American College of Obstetricians and Gynecologists (ACOG).

There is no cure for endometriosis, but treatment typically requires either medication, surgery, or both. If pain is the primary problem, doctors will most likely recommend meds.

4. You have genital herpes.

There are two types of herpes viruses: herpes simplex virus-1 (HSV-1) and herpes simplex virus-2 (HSV-2). HSV-1 causes cold sores (and is extremely common), while HSV-2 is known as genital herpes and is a little less common. The latter can cause painful sores and fluid-filled blisters on your anal or genital area, according to ACOG.

If you notice sores on your anus or your genitals, it’s important to be tested for STIs and to contact all of your sexual partners if you test positive so they can also be tested. Herpes doesn’t have a cure, but it can be managed. Doctors prescribe antiviral medications to lessen the number of outbreaks and to shorten the duration and lessen the severity of an outbreak when it does happen.

5. You have an anal fissure or anorectal abscess.

Anal fissures are splits and cracks in the lining of the anal opening (sounds pleasant, right?). Often, they happen when you have either very hard—or conversely, very watery poop—which can cause irritation to the anus.

The cracks expose the muscle that controls bowel movements, which can lead to burning pain or bleeding after you poop. The resulting tear is easily visible, so all it takes is a doctor’s visit to confirm, according to the U.S. National Library of Medicine (NLM). If your doctor suspects that the fissure was caused by an underlying condition like Crohn’s disease, you may need further testing.

Anorectal abscesses are caused when the tiny anal glands on the inside of the anus become blocked, or an anal fissure becomes infected, per the NLM. The abscesses become filled with pus, which can be painful, and if you have one you’ll have to see your doctor to open and drain the abscess.

6. You have sciatica.

The sciatic nerve is as thick as your thumb and runs from your lower back, down through your buttocks and to your foot. When the nerve gets pinched, it can cause pain, sometimes in the butt. “If irritated, it can feel like a dog bite in the butt,” says Carrie Pagliano, a board-certified clinical specialist in women’s physical therapy and spokeswoman for the American Physical Therapy Association.

Numbness, tingling, and a burning or prickling sensation are also common sciatica symptoms. If you think this might be the cause of your butt pain, you can go to the American Physical Therapy Association‘s website to find a physical therapist in your area.

7. You have piriformis syndrome.

Piriformis syndrome can sometimes be mistaken for sciatica, because the symptoms are very similar. But piriformis syndrome is a neuromuscular condition (a miscommunication between your nerves and muscles) that causes hip and butt pain. Piriformis syndrome is basically cramping and spasming of the piriformis muscle (located behind your gluteus maximus), says Pagliano.

Piriformis syndrome can cause a sharp, radiating pain when you move your hips (so, pain in your butt while walking, siting, running, and so on). This kind of pain, as well as sciatic pain, typically stems from back issues, says Pagliano. Physical therapy, exercise, and stretching can all help treat and manage piriformis syndrome.